Brain metastases and testicular tumors

Need for aggressive therapy

S. G. Lester, J. G. Morphis, N. B. Hornback, S. D. Williams, Lawrence Einhorn

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

In late 1974, the combination of cisplatin, vinblastine, and bleomycin (PVB) became the standard chemotherapeutic regimen for treatment of disseminated nonseminomatous germ cell testicular tumors (NSGCT) at Indiana University Hospital. A retrospective analysis of the treatment records of all patients with brain metastases from NSGCTs treated at the Indiana University Radiation Oncology Department from 1975 through 1982 was undertaken. These 22 patients were divided into four groups. Group 1 (n = 5) consisted of those patients who presented initially with brain metastases and had no prior systemic treatment. Group 2 (n = 4) were referred to Indiana University after failing systemic therapy other than PVB chemotherapy. Group 3 (n = 5) consisted of those patients who after achieving a complete response with PVB developed a relapse confined to the brain. Group 4 (n = 8) consisted of those patients who were initially treated with PVB and eventually developed progressive disease and brain metastases. The survival by group is 80%, 0%, 60%, and 0%, respectively, with the overall survival for the entire group being 31.8%. All patients currently alive have a range of follow-up of 22 to 96 months from diagnosis and 12 to 83 months from whole brain irradiation (WBRT). Group 1 was treated with PVB+/- doxorubicin plus WBRT. Group 3 was treated with surgical excision, when feasible, followed by WBRT and platinum-containing chemotherapy. Group 2 and 4 were usually treated with palliative intent WBRT. The CNS is a site of sanctuary from PVB. Patients with brain metastases who may achieve a complete response should be treated with curative intent and receive aggressive WBRT (5,000 rad/25 fractions) with concomitant chemotherapy.

Original languageEnglish (US)
Pages (from-to)1397-1403
Number of pages7
JournalJournal of Clinical Oncology
Volume2
Issue number12
StatePublished - 1984
Externally publishedYes

Fingerprint

Testicular Neoplasms
Brain Neoplasms
Neoplasm Metastasis
Brain
Therapeutics
Drug Therapy
Radiation Oncology
Survival
Vinblastine
Bleomycin
Brain Diseases
Platinum
Doxorubicin
Cisplatin
Recurrence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Lester, S. G., Morphis, J. G., Hornback, N. B., Williams, S. D., & Einhorn, L. (1984). Brain metastases and testicular tumors: Need for aggressive therapy. Journal of Clinical Oncology, 2(12), 1397-1403.

Brain metastases and testicular tumors : Need for aggressive therapy. / Lester, S. G.; Morphis, J. G.; Hornback, N. B.; Williams, S. D.; Einhorn, Lawrence.

In: Journal of Clinical Oncology, Vol. 2, No. 12, 1984, p. 1397-1403.

Research output: Contribution to journalArticle

Lester, SG, Morphis, JG, Hornback, NB, Williams, SD & Einhorn, L 1984, 'Brain metastases and testicular tumors: Need for aggressive therapy', Journal of Clinical Oncology, vol. 2, no. 12, pp. 1397-1403.
Lester SG, Morphis JG, Hornback NB, Williams SD, Einhorn L. Brain metastases and testicular tumors: Need for aggressive therapy. Journal of Clinical Oncology. 1984;2(12):1397-1403.
Lester, S. G. ; Morphis, J. G. ; Hornback, N. B. ; Williams, S. D. ; Einhorn, Lawrence. / Brain metastases and testicular tumors : Need for aggressive therapy. In: Journal of Clinical Oncology. 1984 ; Vol. 2, No. 12. pp. 1397-1403.
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